ERKEN EVRE MEME KANSERİ HASTALARINDA PATOLOJİK SUBTİPLERE GÖRE D VİTAMİN EKSİKLİĞİ; TEK MERKEZ DENEYİM

Yıl 2022, , 256 - 261, 30.06.2022

Gülcan Bulut , Melis Rıdvanoğulları

https://doi.org/10.34087/cbusbed.1052112

Öz

Giriş ve Amaç: D vitamini, meme kanseri riskiyle ilişkilendirilmiştir. Bu çalışmanın birinci amacı erken evre meme kanserli hastalarda D vitamin eksikliğini ve meme kanseri patolojik subtiplerine göre D vitamini düzeylerindeki farklılıkları göstermektedir.
Gereç ve Yöntemler: Çalışmaya erken meme kanseri tanısı almış toplam 208 kadın hasta dahil edildi. Patolojik Subtiplere göre (Lüminal; HER2 pozitif; Üçlü negatif; Üçlü pozitif) dört gruba ayrıldı ve meme kanseri alt tiplerinin ortalama D vitamini düzeyleri, VKİ ve dosya verileri SPPS programına girildi.
Bulgular: Ortalama yaş 51.37 +/-10.0 idi. 25(OH)D3 düzeyi ortalama 22.3 +/- 10.6 nmol/L idi. Hastaların % 79.1’inde D vitamini seviyeleri eksikti(<30 nmol / L). Hormon pozitif olan meme kanseri patolojik subtipleri ile hormon negatif subtipler kıyaslandığında hormon pozitif lehine D vitamin seviyeleri istatistiksel olarak anlamlı derecede düşük bulundu. Anti-östrojen tedavisi almış veya almakta olan toplam 155 hasta vardı. Anti-östrojen tedavisi almaya devam eden 135 hastanın ortalama D vitamini seviyesi 20,6 nmol / L iken tedavisi tamamlanan 20 hastanın ortalama D vitamini seviyesi 23,5 nmol / L idi. İstatistiksel açıdan anlamlı bir fark saptanmadı.
Sonuç: D vitamini eksikliği meme kanseri alt tipleri ile ilişkili olabilir, ancak hormonal tedavi ile ilişkili olduğu gösterilmemiştir. Özellikle kontrollerine devam eden meme kanseri hastalarında D vitamini replasman tedavisi düşünülmelidir.

Anahtar Kelimeler

Meme kanseri, patolojik subtipler, Vitamin D eksikliği

Destekleyen Kurum

destek alınmamıştır.

Teşekkür

Çalışma tek merkezde yapılmış olup Defne Hastanesi yönetimine verdiği destekten dolayı teşekkür ederiz.

VITAMIN D DEFICIENCY IN PATIENTS WİTH EARLY BREAST CANCER ACCORDING TO PATHOLOGICAL SUBTYPIES; ONE CENTER EXPERIENCE

Öz

Introduction: Vitamin D has been linked to breast cancer risk. The first aim of this study is to show vitamin D deficiency in patients with early stage breast cancer and the differences in vitamin D levels according to breast cancer subtypes.
Materials and methods: A total of 208 female patients diagnosed with early breast cancer were included in the study. According to pathological subtypes (luminal; HER2 positive; triple negative; triple positive). They were divided into four groups and median vitamin D levels, BMI and file data of breast cancer subtypes were entered into the SPPS program.
Results: The median age was 51.37 +/-10.0 The average level of 25 (OH) D3 was 22.3 +/-10.6 nmol / L. Vitamin D levels were deficient in 79.1% of the patients (<30 nmol / L). When hormone-positive breast cancer subtypes and hormone-negative subtypes were compared, vitamin D levels in favor of hormone positive were found to be statistically significantly lower. There were 155 patients in total who had or were receiving anti-estrogen therapy. While the average vitamin D level of 135 patients who continued to receive anti-estrogen therapy was 20,6 nmol / L, the mean vitamin D level of 20 patients whose treatment was completed was 23.5 nmol / L. There was no significant
difference.
Conclusions: Vitamin D deficiency may be associated with breast cancer subtypes, but has not been shown to be associated with hormonal therapy. Vitamin D replacement therapy should be considered especially in patients with breast cancer who continue their follow-up.

Anahtar Kelimeler

Breast Cancer, patological subtype, Vitamin D deficiency

Kaynakça

• 1- Gençtürk N. MEME KANSERİNDE KORUNMA. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi.2010; 72-82.
• 2- Moorman G and Terry PD. Consumption of dairy products and the risk of breast cancer. Patricia Am J Clin Nutr 2004;80.5–14.
• 3- Gezmen Karadağ M, Koçyiğit E. D vitamini sentezi emilimi ve metabolizması. Yurttagül SM, editör. D Vitamini. 1. Baskı. Ankara: Türkiye Klinikleri; 2019. p.1-5.
• 4- Holick MF. Noncalcemic actions of 1,25-dihydroxyvitamin D3 and clinical applications. Bone 1995;17(suppl):107S–11S.
• 5- Apperly FL. The relation of solar radiation to cancer mortality in North America. Cancer Research, 1941, 1, 191-195.
• 6-Welsh J. E. Vitamin D and breast cancer: insights from animal models. Am J Clin Nutr 2004: 80 (supplement) : 1721
• 7-Çevik B., Beslenme ve Kanser Fırat Tıp Derg/Firat Med J 2017; 22(1): 1-7.
• 8- Giovanucci E. The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer causes control, 2005, 16(2), 83-95.
• 9- Kıdır M. D vitamininin immun sistem, deri ve kanser ile ilişkisi. Derleme, SDÜ Tıp Fakültesi Dergisi, 2013, 20(4), 158-161
• 10-Rosen CJ, Adams JS, Bikle DD, Black DM, Demay MB, Manson JE, et al. The Nonskeletal Effects of Vitamin D: An Endocrine Society Scientific Statement. Endocrine Reviews 2012; 33(3): 456492
• 11- Faustino R. Pérez-López, Peter Chedraui and Javier Haya. Vitamin D Acquisition and BreastCancer Risk. ReproductiveSciences 2009; 16: 7-19.
• 12- Colston and Feldman DEMONSTRATION OF 1,25-DIHYDROXYVITAMIN D3 RECEPTORS IN HUMAN SKIN BIOPSIES The Journal of Clinical Endocrinology & Metabolism, Volume 51, Issue 6, 1 December 1980, Pages 1463–1465
• 13-T. S. Sevimli ve ark. Meme kanserinde protein ekspresyon değişimleri Dicle Tıp Dergisi 2013; 40 (1): 161-168
• 14-M.O Şahin ve ark. 1.25 vitamin D3 ve Resöptörlerinin İnsan Kanserlerindeki Yeri Türkiye E kapotoloji Dergisi 2000; 6 (1,2), 73-79
• 15- Friederic M and ark. Relative Expression of 1,25-Dihydroxyvitamin D3 Receptor, Vitamin D 1α-Hydroxylase, Vitamin D 24-Hydroxylase, and Vitamin D 25-Hydroxylase in Endometriosis and Gynecologic Cancers Reprod. Sci. 14, 486–497 (2007).
• 16- Rosen CJ, Adams JS, Bikle DD, Black DM, Demay MB, Manson JE, et al. The Nonskeletal Effects of Vitamin D: An Endocrine Society Scientific Statement. Endocrine Reviews 2012; 33(3): 456492
• 17- Welsh J., Vitamin D and breast cancer: Past and present The Journal of Steroid Biochemistry and Molecular Biology 2018; 177 (15-20)
• 18- Holick MF. Vitamin D: A millennium perspective. J Cell Biochem 2003;88:296-307
• 19-Garland CF, Garland FC, Gorham ED, Lipkin M, Newmark H, Mohr SB and Holick MF. The Role of Vitamin D in Cancer Prevention American Journal of Public Health, 2006; 96(2): 252-61.
• 20- Zehnder, D, Bland, R, Williams, M.C, McNinch, RW, Howie, AJ, Stewart, PM, 2001
• 21- Ooi LL, Zhou H, Kalak R, Zheng Y, Conigrave AD, Seibel MJ, Dunstan CR. Vitamin D deficiency promotes human breast cancer growth in a murine model of bone metastasis. Cancer Research, 2010, 70(5).
• 22-The Journal of Breast Health 2011 Vol:7 No: 2 Meme Sağlığı Dergisi 2011; 7 ( 2)
• 23- Koçak S, The Journal of Breast Health 2011; 7( 2).
• 24- Çerçi A, Vitamin D and Breast Cancer Beslenme ve Diyet Dergisi 2013: 41(2):172-178
• 25-Lazzeroni M, Gandini S, Puntoni M, Bonanni B, Gennari A, DeCensi A. The science behind vitamins and natural compounds for breast cancer prevention. Getting the most prevention out of it. The Breast 2011;20(S3):36- 41.
• 26-Alptekin İ., Anti-Kanser Etkiler Işığında D Vitamini ve Kanser ACU Sağlık Bil Derg 2017(2):70-74
• 27- Fidan F., ve ark. Çağın Pandemisi: D Vitamini Eksikliği ve Yetersizliği Turk J Osteoporos 2014;20(2):71-74
• 28- Shi L, Nechuta S, Gao YT, Zheng Y, Dorjgochoo T, Wu J et al. Correlates of 25-Hydroxyvitamin D among Chinese Breast Cancer Patients. PLOS ONE 2014; 9(1): e86467
• 29-Öztürk T., Meme Kanserinin Diyet ve Yaşam Tarzı İle İlişkisi Nedir Klinik Tıp Aile Hekimliği Dergisi 2016; 8(4).
• 30-Yin L, Grandi N, Raum E, Haug U, Arndt V, Brenner H. Meta-analysis: Serum vitamin D and breast cancer risk. Eur J Cancer 2010;46:2196-2205.
• 31-Sharif BM, Edward DG, June K, Heather H, Cedrif FG. Meta-analysis of vitamin D sufficiency for improving survival of patients with breast cancer. Anticancer research, 2014, 34, 1163-1166.
• 32-Siegel, R. L., Miller, K. D. & Jemal, A. Cancer statistics. CA Cancer J Clin. 66, 7–30 (2016).
• 33-M. de La Puente-Yagu¨e et al. Review ArticleVitamin D: And its role in breast cancer Journal of Medical Sciences (2018) 34, 423e427
• 34- Rainville C, Khan Y, Tisman G. Triple negative breast cancer patients presenting with low serum vitamin D levels: a case series. Cases Journal, 2009, 2, 8390.
• 35-Aypak ve ark. Obez Hastalarda D vitamini Düzeyi Erişkin Obez Hastalarda D vitamini Düzeyinin Vücut Kitle İndeksi ile İlişkisi DOI: 10.4274/Haseki.954
• 36-Tan M et al. The effect of physical activity and body mass index on menopausal symptoms in Turkish women: a cross-sectional study in primary care BMC Women's Health 2014, 14: 38
• 37-Habib, O. S. et al. Epidemiology of Breast Cancer among Females in Basrah. Asian Pac J Cancer Prev. 17, 91–5 (2016).
• 38- Estébanez N.,et al Vitamin D exposure and Risk of Breast Cancer: a meta-analysis Scıentıfıc Reports (2018) 8:9039 DOI:10.1038/s41598-018-27297-1
• 39-Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from Institute of Medicine: What clinicians need to know. J Clin Endocrinol Metab 2011;96:53-58.
• 40- Colston, K. W. & Hansen, M. Mechanisms implicated in the growth regulatory efects of vitamin D in breast cancer. Endocr Relat Cancer. 9, 45–59 (2001)